Loss of Homotypic Epithelial Cell Adhesion by Selective N-Cadherin Displacement in Bismuth Nephrotoxicity

The nephrotoxicity of single high doses of bismuth (Bi)-containing therapeutic drugs is characterized morphologically by detachment of proximal tubular epithelial cells (PTECs) from each other, followed by cell death. We investigated whether Bi nephrotoxicity is mediated by changes in the distribution of proteins involved in intercellular adhesion. A nephrotoxic dose of colloidal bismuth subcitrate (CBS; 3.0 mmol Bi/kg) was orally administrated to 10 female Wistar rats. After 1 h, N-cadherin had disappeared from the adherence junctions of vital PTECs, whereas ZO-1, a tight junction marker, remained present at the cell–cell border until cell death occurred after 3 h. E-Cadherin, absent in PTECs, remained absent. Exposure of the renal epithelial cell lines NRK-52E and LLC-PK1 to 400 μM Bi3+ also resulted in the disappearance of N-cadherin expression after 1 h, whereas ZO-1, E-cadherin, and Desmoplakin expression did not resolve before cell death at 24 h, thus confirming in vivo results. Our results are the first to indicate that Bi-induced death of PTECs is preceded by redistribution of N-cadherin and the disruption of homotypic cell adhesion.